Provider Demographics
NPI:1588482798
Name:HARRIS, BRIAN JEFFERY (LMSW, LMAC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:JEFFERY
Last Name:HARRIS
Suffix:
Gender:M
Credentials:LMSW, LMAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 SW 39TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66609-1360
Mailing Address - Country:US
Mailing Address - Phone:785-213-9076
Mailing Address - Fax:785-833-2040
Practice Address - Street 1:900 SW 39TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66609-1360
Practice Address - Country:US
Practice Address - Phone:785-213-9076
Practice Address - Fax:785-833-2040
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11911101YM0800X
KS00966101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health